Tracking Complications And Unplanned Healthcare Utilization In Aesthetic Surgery: A Nationwide Analysis Of 221,584 Patients Using The Tops Database
Amanda R. Sergesketter, MD1, Ronnie L. Shammas, MD1, Shen Yin, PhD2, Howard Levinson, MD1, Evan Matros, MD2, Brett T. Phillips, MD, MBA1.
1Duke University, Durham, NC, USA, 2Memorial Sloan Kettering Cancer Center, New York, NY, USA.
PURPOSE: Tracking surgical complications and unplanned healthcare utilization is essential to inform quality initiatives in aesthetic surgery. This study utilized the Tracking Operations and Outcomes for Plastic Surgeons (TOPS) database to characterize rates and predictors of surgical complications and unplanned healthcare utilization across common aesthetic surgery procedures.
METHODS: The TOPS database was queried for all patients undergoing breast augmentation, liposuction, blepharoplasty, rhinoplasty, and abdominoplasty from 2008-2019. Incidence and risk factors for complications and unplanned readmission, reoperation, and emergency room visits were determined.
RESULTS: A total of 221,584 patients were identified. Overall, 99,488 breast augmentations, 58,249 liposuction procedures, 30,227 blepharoplasties, 25,151 abdominoplasties, and 8,469 rhinoplasties were included. A low incidence of peri-operative complications was found, including seroma (1.1%), hematoma (0.7%), deep wound complication (0.9%), deep surgical site infection (0.2%), need for need for blood transfusion (0.05%), and DVT/PE (0.1%). Incidence of unplanned readmission, emergency room visits, and reoperation were 0.33%, 0.25%, and 0.79%, respectively. Patients who underwent an abdominoplasty more commonly presented to the emergency room and had unplanned readmissions or reoperations compared to other studied procedures. Furthermore, an increased age, diabetes, higher BMI, ASA class, prolonged OR time, and pursuit of combined aesthetic procedures were associated with increased risk for unplanned healthcare utilization.
CONCLUSIONS: There is a low incidence of perioperative complications and unplanned healthcare utilization following common aesthetic surgery procedures. Continued entry into large national databases in aesthetic surgery is essential for internal benchmarking and quality improvement.
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